What is Hernia?
A hernia is an outpouching of viscera beyond its anatomical confines. It’s most common in the abdomen, but can also occur in the groin, navel, and umbilicus. Hernias can also occur in the chest, diaphragm, and even in the neck and shoulder area. The most common abdominal wall hernia is the inguinal hernia. In this type of hernia, both males and females are susceptible although males have a higher predisposition. The risk factors for hernia include modifiable and non-modifiable.
Modifiable risk factors include:
- Lifestyle include heavy weight lifting
- Smoking leading to chronic cough
- Chronic constipation
- Straining from urinary difficulties
Non-modifiable risk factors include:
- Male gender
- Being white
- Previous surgery for hernia
There are several types of hernia:
- Inguinal hernia – This is the most common type of hernia, occurring when part of the intestine pushes through a weak spot in the lower abdomen near the groin area.
- Femoral hernia – This type of hernia occurs when part of the intestine pushes through a weak spot in the upper abdomen near the groin area.
- Ventral hernia – This type of hernia occurs when part of the intestine pushes through a weak spot in the abdomen wall.
- Incisional hernia – This is a type of hernia that occurs after a surgical incision.
- Hiatal hernia – This type of hernia occurs when part of the stomach pushes through an opening in the diaphragm.
- Umbilical hernia – This type of hernia occurs when part of the intestine pushes through a weak spot in the abdominal wall near the umbilicus (belly button).
What are the Symptoms of Hernia?
When it comes to hernia symptoms, it’s important to understand that not all hernias cause symptoms. However, some of the common symptoms associated with hernias include a visible lump or bulge that appears during certain activities or in certain physical positions and goes back in at other times.
You may also feel pressure, a dull ache or pinching when the hernia comes out. It may come out when you’re straining, lifting, laughing or coughing. In the case of an abdominal hernia, you may experience nausea and/or vomiting, loss of appetite, and decreased bowel movements.
You may also feel a pulling sensation in the affected area. Additionally, some people may experience pain and discomfort when they’re trying to pass gas or strain to use the bathroom. A hernia can also cause abdominal tenderness and a feeling of fullness in the abdomen.
If a hernia becomes incarcerated, it may become difficult or impossible to push the hernia back into the abdomen. Additionally, if the hernia is strangulated, it can cut off the blood supply to the hernia, leading to serious complications. If you suspect that you may have a hernia, it’s important to seek medical attention as soon as possible.
Your doctor can diagnose a hernia based on a physical exam and imaging tests, such as an ultrasound or CT scan. Depending on the type and severity of the hernia, your doctor may recommend surgery as a treatment option.
No matter what type of hernia you have, it’s important to be aware of the common symptoms. If you experience any of the symptoms associated with a hernia, it’s important to seek medical attention right away.
What are the Possible Complications of Hernia?
When it comes to hernias, complications can vary depending on the type of hernia and the degree to which it is impacting your life. A hernia occurs when an organ or tissue pushes through a weak spot or hole in the muscle or connective tissue that holds it in place. Hernias can develop in different areas of the body, such as the abdomen, groin, or even the diaphragm.
The most common complication of a hernia is incarceration, which is when the hernia gets stuck and can’t move back in. This can be incredibly painful, and if the hernia is in the bowel, it can cause an obstruction that prevents food or gas from passing through. If the hernia is incarcerated and doesn’t have access to blood supply, this can lead to tissue death, or necrosis or gangrene.
Diaphragmatic hernias, on the other hand, typically don’t lead to complications, except for hiatal hernias, which can cause chronic acid reflux. Congenital diaphragmatic hernias (CDH) are more complicated because they impact the way the fetal organs develop. Babies born with CDH are critically ill and require intensive care.
Overall, hernias can range from minor to serious, so it’s important to be aware of the possible complications and seek medical help if you’re experiencing any signs or symptoms of a hernia. Your doctor can help you determine the type of hernia you have and provide the best treatment plan and follow-up care. With the right care, many hernias can be managed without any major complications.
How is Hernia Diagnosed?
Diagnosis of a hernia can be a simple process, depending on the type of hernia you have. In most cases, your healthcare provider can diagnose a hernia with a simple physical exam. Through the physical exam, they will be able to identify any lumps or bulges in your abdomen and groin area, which may be an indication of a hernia.
If your healthcare provider can see or feel the hernia, they may be able to determine its severity by attempting to reduce it — which is to attempt to make the hernia go back inside the body. In some cases, a hernia may be too small or deep for your healthcare provider to feel or see it during a physical examination.
If this is the case, they may order a soft tissue imaging such as a CT scan. A CT scan is a type of imaging test that uses X-rays to create detailed pictures of the inside of your body. With this test, your healthcare provider will be able to identify the size, severity, and location of the hernia.
If you are experiencing pain or discomfort in the abdominal area or groin, it is best to speak to your healthcare provider to determine if it is caused by a hernia. They will be able to provide you with a diagnosis and any necessary treatment.
It is important to note that hernias can be dangerous if left untreated, so it is important to get it looked at as soon as possible. If you think you may have a hernia, make sure to schedule an appointment with your healthcare provider.
What are the Treatment Options for Hernia?
Conservative Measures for Hernia Management
The modifiable risk factors should be mitigated to prevent any worsening of the hernia. In addition, wearing a hernia truss helps to minimize discomfort and reduces the chance of complications by keeping the hernia reduced.
The complications for hernia include intestinal blockage or obstruction, strangulation or intestinal perforation. Most hernia patients are asymptomatic or only having mild discomfort at the initial stage.
It is advisable to see a physician early for a consultation on the necessity for surgery. Although the risk of complications is low, the risk of the surgery also increases with advancing age and increasing hernia size. Hence, a balanced approach should be adopted for the need for hernia surgery.
Open Hernia Mesh Repair
An incision is made on the affected side and the hernia contents are reduced. With the excess sac removed, the normal anatomy is restored with the use of a mesh to encourage healing of the weak part of the abdominal wall. Mesh repair is the standard of care as the lack of tension in such repairs results in a significant decrease in the risk of recurrence.
Laparoscopic Hernia Mesh Repair
Which include TEP, TAPP and IPOM Laparoscopic hernia repair and their various techniques are employed for different situations. The most performed approach would be the totally extra-peritoneal approach (TEP). In general, the laparoscopic approach has benefits of being able to repair hernias from both sides at the same time and minimizing the post-operative pain.
What Happens if Hernia is Left Untreated?
When a hernia is left untreated, the opening in the abdominal wall can continue to stretch and weaken, allowing more tissue to push through. This can lead to the hernia becoming “incarcerated,” which means that the tissue is stuck in the hernia and can no longer be pushed back in.
If a hernia becomes incarcerated, it can lead to a strangulated hernia. In this case, the hernia has completely blocked the blood supply to the tissue, leading to tissue death and the potential for infection. This type of hernia is considered a medical emergency and can require surgery to repair.
In addition to being painful, an incarcerated hernia can lead to other complications such as obstruction or perforation of the intestine. This can cause nausea, vomiting, and abdominal pain. If a hernia is left untreated for too long, the intestines can become twisted, resulting in a life-threatening condition called an intestinal volvulus.
In summary, hernias are a common problem, but if left untreated, they can become much more severe. If you suspect you have a hernia, it’s important to seek medical attention right away. Treatment options vary depending on the size and type of hernia, but early diagnosis and treatment are essential to avoid complications.